What is Anxious Depression?

Anxiety and depression often come together. And there's different ways this can look. Sometimes anxiety spawns depression, where you start off with something like obsessive compulsive disorder where you have these overwhelming thoughts that you can't get out of your head or rituals that you can't stop doing. Or you may have generalized anxiety disorder where you are gripped with worry and fear. Some people's anxiety can be so bad that they wake up every morning and throw up. Or you can feel like there's a heavy weight pressing on you all day. Some people feel like their throat is closing all day long. This is a horrible way to feel. Especially when there's not a clear reason to feel anxious. You can start to think – what's wrong with me? Why can't I feel normal? Feeling like this for weeks or months on end can make some people sink into a depression. In this case, you would have two disorders, the original anxiety disorder and then a depression.

That's one scenario. Another scenario is when your primary problem is depression – having no joy, feeling hopeless, hardly having the energy to do anything. Instead of feeling a heavy weight on your chest all day, you feel tears just behind your eyes all day ready to stream at the slightest provocation.

This is what your depression might look like if you had pure depression. But many times people have anxiety symptoms mixed in with their depression. The anxiety doesn't rise to the level of a full disorder like panic disorder or generalized anxiety disorder. But it's presence is enough to make the quality of your depression different. The term for this is depression with anxious distress. Anxious distress is what we call a course specifier. It gives more specific information about how your depression looks and behaves.

Here is the criteria for this specifier. This is from the diagnostic and statistical manual of mental disorders, 5th edition.

Anxious distress is defined as the presence of at least two of the following symptoms during the majority of days of a major depressive episode or persistent depressive disorder (dysthymia):
Feeling keyed up or tense.
Feeling unusually restless.
Difficulty concentrating because of worry.
Fear that something awful may happen.
Feeling that you may lose control of yourself

If you have depression with anxious distress, be prepared that you may need more than one medication to treat your condition and you may have a try a few before you get one that works well with the least amount of side effects.

Refences
Zhao K, Liu H, Yan R, et al. Cortical thickness and subcortical structure volume abnormalities in patients with major depression with and without anxious symptoms. Brain Behav. 2017;7(8):e00754.

Fu CH, Steiner H, Costafreda SG. Predictive neural biomarkers of clinical response in depression: a meta-analysis of functional and structural neuroimaging studies of pharmacological and psychological therapies. Neurobiol Dis. 2013;52:75-83.

Ionescu DF, Niciu MJ, Richards EM, Zarate CA Jr. Pharmacologic treatment of dimensional anxious depression: a review. Prim Care Companion CNS Disord. 2014;16(3)

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[tasha]

it’s been so long that i genuinely can’t remember myself without anxiety or depression. it consumes me and controls every aspect of my life. i’m so tired.

[dennisbryan]

I just feel like crying for no apparent reason and I have this overwhelming feeling of sadness

[Krystal_Hope]

Anyone watching and feeling these symptoms like I am. You’re not alone, and we are going to make it! ♥️

[DrumWild]

The problem with it all is that our modern society provides many legitimate reasons for anxiety, depression, and anxious depression. A pill and therapy might relieve these symptoms, but they do absolutely NOTHING to alleviate ANY of the causes.

[Sean.A.M]

"You still hurt even after you've cried" Ouch that cut deep.

[katherineheasley]

I just want to encourage people. I was diagnosed with a combination of anxiety and depression many years ago. I went on medication, we tinkered with the dosage and combination, I did talk therapy, I worked on myself, and while I won't say everything's perfect, I have a good life, one which I'm grateful for. Since being diagnosed, I've lived and worked in three countries and gotten a Master's degree, and now I have a great job and a stable life. It took time and effort on everyone's part - mine, my doctors', my support system's - but I did it. The depression is banished to occasional lows. I'm functional and, overall, happy. I hope everyone can get the help and support they need.

[jaydenlee]

depression is the real deal. I pray and hope anybody going through this can keep their head up, and may god heal your soul

[jobbe]

I have been deeply depressed and anxious since I was about 14, I am now 32!
This has literally stopped me from doing my dream job, meeting someone and leading a life.

[Daniel-dlcu]

That weight feeling is something new I've experienced. It really does feel like a literal weight, or like a heavy cloud feeling. It's shocking how physical it is.

[patriaciasmith]

Psilocybin saved my life. I was addicted to heroin for 15 years and after Psilocybin treatment I will be 3 years clean in September. I have zero cravings. This is something that truly needs to be more broadly used in addiction treatment.

[jesusvelazquez]

It's hell. It's horrible. To anyone out there struggling. Stay strong. I get you. Your not crazy. Much love.

[potatopewpew]

Does anyone have this anxiety symptom, it’s like feeling like everything is familiar, or things are constantly reminding me of past events, also getting random memories or places popping into my head, totally insignificant to anything I’m doing . Anyone else experienced something like this or know why ? It’s just so annoying, and triggered my anxiety and makes me depressed.

[AmbiPanby]

Always a shock to remember not everybody has all 5 symptoms. 😅 Throwing ADHD unto the mix can really muddy up the anxious depression diagnostic criteria because I think we regularly experience all these things too, but it may stem from the trauma of being neurodivergent in a neurotypical world.

[fana]

I Just love her voice and the way she speaks and explains. It gives me some kind of calm ess 🧡💛💚💙

[yellow-t]

I have both and its not separated. It came together with a package.

[zigzaglychee]

I used to wake up every morning with a racing heart. My chest would hurt all day. I would cry all the time and spend all day ruminating over things I was worried about. I could never see the good in anything. I'm doing so much better now ^_^ antidepressants worked very well for me and now I'm less irritable and can handle things much better and enjoy life

[carabeatriz]

People who's suffering from anxiety/ anxious depression
SHOULD NOT BE JUDGE.. THEY NEED HELP GUYS..

[emm]

Anxious depression is hideous, I was unable to work for months because of it. It made me physically sick as described in this video. It’s nice to hear it described so clearly!

[Chloe-bwdf]

Omg how did she know

She says that you feel a heavy weight on you all day and I feel like I’m trapped in a box with rocks on my chest all the time.

[reallifepsych]

Thank you so much for bringing up the treatment resistant category and that people with anxious depression are harder to treat. So many people get increasingly frustrated because they don’t get better and cycle back into their depression. This video was very important.